Cerrahi Tıp Bilimleri Bölümü Koleksiyonu

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https://hdl.handle.net/20.500.12428/2266

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Evaluation of triply periodic minimal surface geometries in 3D-printed PLA scaffolds for chondrogenic differentiation
(Wiley, 2025) Kılıç, Mahmut Alp; Akyürek, Mustafa; Abidnejad, Roozbeh; Karakoç, Alp
Triply periodic minimal surface (TPMS) scaffolds are gaining attention in tissue engineering due to their continuous and interconnected porous architecture. In this study, three TPMS geometries-Gyroid, Diamond, and I-WP-were fabricated from polylactic acid (PLA) using fused deposition modeling (FDM), with all scaffolds designed to maintain the same overall porosity. Scaffold characterization included scanning electron microscopy (SEM), microcomputed tomography (micro-CT), compressive mechanical testing, and surface wettability analysis. Although porosity was constant, differences in Equivalent Circular Diameter (ECD) values were observed among the geometries, reflecting variations in pore morphology. Adipose-derived stem cells (ADSCs) were seeded onto the scaffolds and cultured under chondrogenic differentiation conditions for 21 days. Cell viability, gene expression (Col2, Col10, Sox9), and protein levels were assessed using RT-PCR and Western blot. All scaffold geometries supported cell attachment and chondrogenic differentiation to varying degrees. The Diamond geometry showed the highest chondrogenic marker expression at the mRNA level, while the Gyroid geometry promoted more stable protein expression with reduced hypertrophic signaling. These findings demonstrate that scaffold geometry, even under identical material and porosity conditions, can influence stem cell behavior. The results offer valuable insights for optimizing TPMS-based scaffold designs in cartilage tissue engineering applications.
A note on the history of Hirschsprung's disease, and an over 120 years apology
(Springer, 2025) Celayir, Ayşenur; Çetiner, Handan; Aldırmaz Ağartan, Canan; Günaydın, Reyhan; Celayir, Arın
In 1886, Harald Hirschsprung presented what he believed to be a new and rare condition at the Berlin Congress for Children's Diseases. In 1888, still unaware of earlier reports, he published a paper titled Constipation in Newborns as a Consequence of Dilation and Hypertrophy of the Colon, suggesting that the enlargement of the colon was congenital. Although he noted a narrowing of the rectum in his initial case, Hirschsprung attributed this condition to a dilated intestine rather than a narrowed rectum. In fact, F. Ruysch had described a case of over-enlarged colon as early as 1691, and in 1800, D. Battini published another case of severe constipation posthumously. Between 1825 and 1888, around 20 similar cases had been documented in medical literature. K. Tittel was the first person to draw attention to the narrow rectum and the absence or scarcity of ganglion cells in this region in 1901. However, he did not identify this as the exact cause of the disease, This was evident not only in his own article but also in references to his work in other publications. Despite this fact in the literature, the disease is known as Hirschsprung Disease. Given the historical and scientific context, it may be time to reconsider the attribution of K. Tittel's discovery and to recognize the significant contributions of him in understanding of this disease.
Chronic low back pain and exercise: a molecular perspective on aerobic and anaerobic core training
(Springer, 2025) Aykora, Emrah; Akar, Ali; Eroğlu, Hüseyin Avni
Chronic low back pain (CLBP) remains a significant challenge for clinicians, and a substantial percentage of adults experience it at some point in their lives. Non-pharmacological treatments have gained attention for managing pain through aerobic and anaerobic core exercises. However, studies on humans and animals have yielded conflicting results regarding the type of exercise and its effect on pain sensation. The pain sensitivity of CLBP patients largely depends on their physiological and psychological conditions. The most studied and supported non-drug treatments for managing CLBP are aerobic core workouts. Recently, new research has also shown promising benefits of anaerobic core exercises, which can help reduce discomfort. Both aerobic and core anaerobic exercises have distinct yet complementary roles in managing CLBP. Aerobic training enhances overall health and endurance, while core anaerobic exercises focus on stabilization and muscular support. Understanding how they work individually and together can help create more effective, personalized exercise plans for long-term CLBP management. These exercises are especially effective in correcting postural issues and lowering mechanical stress on the lumbar spine. Although the exact mechanisms are still unknown, both types of exercises have the potential to lessen pain. This scoping review discusses the pathophysiological processes and exercise-induced hypoalgesia related to CLBP therapy. Additionally, it explores the pain-related molecular mechanisms associated with both aerobic and anaerobic core exercises.
Evaluating Large Language Model Adherence to AAOS Knee Osteoarthritis Guidelines: A Comparative Study of ChatGPT and NotebookLM
(Springer Heidelberg, 2025) Yıldız, Cemil; Gökmen, Mehmet Yiğit; Utlu, Çetin; Karabay, Elif Sude; Tanık, Uğur; Pazarcı, Özhan
Purpose This study evaluated how closely large language models (LLMs), specifically ChatGPT (OpenAI) and NotebookLM (Google), adhere to orthopedic guidelines. The objective was to determine whether AI-generated reasoning aligns with the 2021–2022 American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines for knee osteoarthritis (OA). Methods A mixed-methods design combined quantitative concordance scoring with qualitative content analysis. Thirty-three decision points covering non-arthroplasty and surgical management were derived from AAOS guidelines. Structured Population–Intervention–Comparison–Outcome (PICO) prompts were presented to each model. Two orthopedic surgeons independently rated all outputs using a four-domain rubric assessing accuracy, evidence reasoning, additional information, and knowledge integration (0–4 scale). Concordance was classified as full (4), partial (3), or discordant (≤ 2), with disagreements resolved through consensus. Inter-rater reliability was almost perfect (weighted κ = 0.87). Results ChatGPT achieved a mean composite score of 3.67 ± 0.92, and NotebookLM 3.55 ± 0.87, with no significant difference between models (p = 0.18). Full concordance with AAOS recommendations occurred in 84.8% of ChatGPT responses and 75.8% of NotebookLM responses. Both models performed consistently in high-evidence domains such as NSAID therapy, tranexamic acid use, and weight-loss counseling. Variability increased in limited-evidence or technology-driven areas. Partial concordance reflected the omission of evidence qualifiers, while discordant responses involved overstated or speculative interpretations. Conclusion Both LLMs demonstrated strong alignment with evidence-based orthopedic reasoning. ChatGPT showed slightly higher fidelity to recommendation strength, whereas NotebookLM provided broader contextual interpretation. Structured, guideline-oriented prompting may enhance AI reasoning consistency and support the potential role of LLMs as complementary tools for evidence translation and orthopedic education.
The Effect of Oleuropein on the Treatment of Allergic Rhinitis
(Georg Thieme Verlag Kg, 2025) Çil, Özge Çağlar; Büyük, Başak; Eroğlu, Hüseyin Avni; Şehitoğlu, Hilal
Introduction Allergic rhinitis is a disease that negatively affects social and work life and sometimes does not respond to many treatments. Therefore, new treatments are needed. For the prevention and treatment of allergies, oleuropein has been emphasized, and positive results have been shown in the literature. Objective To investigate the effects of general and topical oleuropein during the allergic rhinitis period and the histopathological changes in the nasal mucosa compared with steroid nasal sprays and control group in rats. Methods We developed an experimental animal model with 44 rats divided into 6 groups. Except for the control group, the allergic rhinitis in the other five groups was created with ovalbumin. As treatment, saline was administered to group 3, steroids, to group 4, oleuropein, to group 5, and steroids and oleuropein were administered to group 6. The effects of the drugs were examined histopathologically and the levels of immunoglobulin E (IgE) in the blood were compared. Results Considering the symptomatic findings in rats, we could observe that allergic rhinitis occurred. Based on the IgE levels and histopathological findings, we have statistically shown that oleuropein may be effective in treatment of allergy rhinitis. Conclusion Oleuropein has been shown to be useful in the treatment of allergic rhinitis in an animal model, but further studies are needed before it is introduced into the medical practice.
Lactate-albumin ratio improves combined predictive value of qSOFA and MEWS for 30-day mortality in ICU patients with sepsis: A retrospective cohort study
(Lippincott Williams & Wilkins, 2025) Ünal Çetin, Ece; Kurtkulağı, Özge; Kamış, Fatih; Daş, Murat; Şimşek, Esen; Çetin, Adil Uğur; Demirer Aydemir, Ferhan; Beyazit, Yavuz
Evaluating disease severity and predicting adverse outcomes using various risk prediction tools in early disease stages is essential to reduce sepsis-related mortality. Unfortunately, there is still no clear consensus on the best score. The present study aimed to develop and validate a multivariable risk prediction model for 30-days mortality by combining the lactate-to-albumin (L/A) ratio, Modified Early Warning Score (MEWS), and quick Sequential Organ Failure Assessment (qSOFA) in sepsis patients admitted to the intensive care unit (ICU). This retrospective study included ICU patients with suspected sepsis. We computed L/A ratio, MEWS, and qSOFA within 24 hours of ICU admission. Patients were followed until either death/hospital discharge or 30 days, whichever came first. The predictive performance of each scoring system and their combinations was assessed using logistic regression and receiver operating characteristic curve analyses. A total of 130 patients with sepsis admitted to the ICU were included in the study. The mortality rate was 63.07% (82/130). A higher L/A ratio, MEWS, and qSOFA were found to be associated with mortality in ICU sepsis patients. A statistically significant difference in terms of predicting mortality was demonstrated in the pairwise comparison after combining the L/A ratio with both the qSOFA and MEWS (difference between areas: -0.098, P = .011 and difference between areas: -0.098, P = .013 respectively). Mortality models combining L/A ratio with selected clinical variables have improved mortality prediction performance compared with models that use MEWS and qSOFA alone. The L/A ratio at ICU admission provide valuable prognostic information for predicting 30-days mortality in sepsis patients. Combining these ratio with MEWS and qSOFA improves the accuracy of predicting mortality in patients with sepsis.
Feeling Underqualified and out of My League: Motivational and Affective Paths to Adaptive and Maladaptive Behaviors
(Sage Publications Inc, 2025) Köseoğlu, Gamze; Keem, Sejin; Karaeminoğulları, Ayşegül; Erdoğan, Berrin; Bauer, Talya N.; Sancak, Eyüp Burak
This study explored the motivational and affective implications of perceived underqualification, specifically examining how it leads to increased levels of envy and help-seeking behaviors. We predicted that envy and help seeking behaviors would in turn indirectly relate to interpersonal deviance and task performance. We further hypothesized that two psychological resources, hope and self-efficacy, would moderate the relationships between perceived underqualification, envy, and help seeking. We tested our model with a sample of 149 medical school students who were undergoing a clinical rotation as well as their rotation coordinators at a university hospital located in northwestern Turkey. Data collection spanned four waves, from the first day of their rotation to the end of that one-month rotation. Results supported positive indirect effects between perceived underqualification and task performance via help seeking, and between perceived underqualification and interpersonal deviance via envy. Further, hope moderated the relationship between perceived underqualification and task performance via help seeking, and self-efficacy moderated the relationship between perceived underqualification and envy.
Effectiveness of Duct Excision Procedures in Detecting Preneoplastic and Malignant Lesions in Pathological Nipple Discharge: A Retrospective Cohort Study
(Wiley, 2025) Ata, Batuhan; Karadağ, Volkan; Çetin, Kenan
Background and Aims Nipple discharge ranges from benign to pathological, indicating inflammation or epithelial proliferation. In 5%–28% of cases, pathological nipple discharge (PND) may indicate breast carcinoma. Our objective was to evaluate the detection rates of malignant and high-risk lesions (HRL) in patients undergoing major duct excision (MDE) and microductectomy for diagnostic purposes due to PND and to assess the need for re-excision in malignancies. Method Patients diagnosed with PND between October 2015 and December 2023 underwent duct excision procedures after physical, imaging, and histopathological examinations, if necessary. Patients with malignancies detected by histopathological evaluation underwent oncological procedures and were excluded from the study. Results Among 118 patients, 80 underwent microductectomy and 38 underwent MDE. Intraductal lesions (ILs) were detected in 62% of cases, with higher detection rates in the microductectomy group (69% vs. 47%, p < 0.03). Of these lesions, 23 were classified as HRL (24% in the microductectomy group vs. 11% in the MDE group, p = 0.09). Malignancy was detected in 16 patients (13.6%), with a higher rate in the MDE group (18% vs. 11%, p = 0.3). Five patients required re-excision for clear surgical margins, with no significant difference between the groups (microductectomy: n = 2; MDE: n = 3, p = 0.3). Conclusion The malignancy detection rate was slightly higher in the MDE group; however, this difference was not statistically significant. Similarly, there was no significant difference in the need for re-excision. Microductectomy, which preserves lactation function, may be preferred for premenopausal individuals or those considering future pregnancies when clinical presentation supports single-duct involvement. The differing distribution of IL and HRL between procedures reflects the pathology associated with their respective clinical indications rather than a difference in diagnostic performance.
Do fistula flow rate and fistula location have any effects on heart failure developing in patients with arteriovenous fistula?
(Bmc, 2025) Yümün, Gündüz; Donbaloğlu, Mehmet Okan; Gürkan, Selami; Gür, Özcan; Demirkıran, Aykut
Background This study aims to explore the effects of arteriovenous fistula locations in the arm and fistula flow rates on the potential development of heart failure in patients with arteriovenous fistula (AVF). Material and methods A total of 116 patients with AVF due to chronic kidney disease were retrospectively reviewed between January 2022 and August 2022. Fifty-six patients with distal AVFs and 60 with proximal AVFs were compared in terms of demographic, clinical, and echocardiographic characteristics. Fistula flow rates were assessed using Doppler ultrasonography, while cardiac parameters were evaluated with echocardiography. The correlation between fistula location and cardiac parameters was analyzed using ROC analysis. Results The mean AVF blood flow rate was 1.47 (0.57–2.9) L/min for proximal fistulas and 0.85 (0.52–2.3) L/min for distal fistulas. There were statistically significant differences between the proximal and distal AVF groups regarding cardiac index, cardiac output, and cardiopulmonary recirculation values (p< 0.001). According to the New York Heart Association classification, Class III can be categorized as high cardiac output failure (HCOF), as cardiac index was calculated at 6.87 ± 1.65 L/min/m² (4.7–9.4), fistula flow rate at 2.60 L/min (2.1–2.9), and cardiac output at 8.08 ± 0.69 L/min. Conclusions When heart failure develops in patients with AVF, underlying heart disease should not be the sole factor considered. Proximal high-flow AVFs, in particular, may contribute to heart failure development and warrant careful monitoring.
Comparative efficacy of erector spinae plane block versus surgeon-performed intraoperative intercostal nerve block in video-assisted thoracoscopic surgery: a retrospective analysis
(Bmc, 2025) Kına, Soner; Batıhan, Güntuğ; Türkan, Hüseyin; Bektaş, Yekta
Background Video-assisted thoracoscopic surgery (VATS) offers reduced postoperative pain and faster recovery, yet optimal analgesia remains essential. Regional anesthesia techniques, such as the erector spinae plane (ESP) block and intercostal nerve block (ICNB), are commonly employed. This study compares preoperative ESP block with surgeon-performed intraoperative ICNB in VATS patients. Methods In this retrospective study, 82 patients (≥ 18 years; ASA I–III) underwent elective VATS between January 2020 and December 2022 were analyzed. Forty patients received a postoperative ESP block and 42 an intraoperative ICNB. Primary outcomes included postoperative pain scores using the Visual Analog Scale, postoperative peak expiratory flow (PEF), postoperative IV opioid analgesic use, drainage time, and hospital length of stay. Results Baseline demographics were similar. VAS scores were comparable at postoperative 1, 3, 6, 12 and 24 h. At postoperative 48 h, the ICNB group had significantly lower VAS scores (4.17 ± 1.03 vs. 4.78 ± 1.03; p = 0.00987). No significant differences were observed in postoperative iv opioid analgesic use, drainage time or hospital stay. Conclusions Both techniques provide effective early analgesia in VATS, with ICNB showing prolonged pain relief. Further prospective studies are warranted.
Transbronchial EBUS-guided aspiration of a loculated pleural collection following right superior bilobectomy: a case report
(Bmc, 2025) Batıhan, Güntuğ; Topaloğlu, İhsan
Background Postoperative loculated pleural collections can mimic empyema and present diagnostic challenges, especially when transthoracic access is limited due to altered anatomy. Case presentation We present the case of a 67-year-old male who developed a pleural collection six months after right superior bilobectomy for central squamous cell lung carcinoma. Due to mediastinal shift and limited transthoracic access, EBUS was used under LMA ventilation to access the loculated pleural pocket adjacent to the right paratracheal region. This unconventional but anatomically justified approach allowed safe sampling when standard ultrasound-guided thoracentesis was not feasible, demonstrating a minimally invasive diagnostic alternative in complex postoperative thoracic anatomies. A total of 15 cc pleural fluid was aspirated, which grew Streptococcus pneumoniae. The patient responded well to antibiotics and remains asymptomatic at 9 months. Conclusions This case highlights a novel application of EBUS in post-surgical thoracic anatomy, offering a minimally invasive alternative when conventional aspiration routes are inaccessible.
Clinical and surgical outcomes of pediatric pelvic fractures: experience from a mass-casualty and routine trauma cohort
(Bmc, 2025) Sarı, Bedirhan; Gökmen, Mehmet Yiğit; Pazarcı, Özhan
Background Pediatric pelvic fractures are rare but potentially life-threatening injuries associated with high-energy trauma and complex anatomical considerations. Surgical management is often required, necessitating multidisciplinary care. This study aimed to evaluate the clinical outcomes of surgically treated pediatric pelvic fractures, with special emphasis on earthquake-related injuries. Methods This retrospective, single-center study included 36 pediatric patients (aged 0–17) who underwent surgical treatment for pelvic fractures between January 2021 and October 2024. Demographics, injury mechanisms, fracture types (Torode and Zieg classification), surgical procedures, and short-term outcomes were analyzed. A subgroup comparison was performed between earthquake-related and non-earthquake trauma cases. Results Earthquake-related trauma was the most frequent mechanism (36.1%), followed by motor vehicle accidents (30.6%) and falls from height (25%). Type IVB fractures were the most common (55.6%). Earthquake-related cases showed longer time to surgery (8.5 vs. 2.3 days, p < 0.001) and higher postoperative CRP (116.7 vs. 33.2 mg/L, p < 0.001). Despite greater injury severity, the majority of patients achieved functional recovery: 63.9% regained full mobility, while 33.3% walked normally with limited running. The overall complication rate was low (16.6%), and no life-threatening events occurred. Hospitalization costs were higher in earthquake cases, driven by Intensive Care Unit (ICU) stay and surgical delay. Conclusion Surgical stabilization of pediatric pelvic fractures achieved favorable short-term outcomes with low complication rates, even in earthquake-related mass-casualty settings. Earthquake cases presented with more severe patterns, longer time to surgery, and greater inflammatory and resource burdens, underscoring the need for rapid triage, coordinated multidisciplinary care, and early mobilization despite operational constraints. These findings argue for disaster-ready pediatric trauma systems and merit validation in prospective multicenter cohorts with long-term functional and economic endpoints.
The effect of Tannic acid on colonic anastomosis in abdominal sepsis: An experimental study
(Public Library Science, 2025) Çıkman, Öztekin; Taş, Şükrü; Özkan, Ömer Faruk; Ercan, Umut; Türkon, Hakan; Kılıç, Nihal; Akgün, Yılmaz; Karaayvaz, Muammer
Background This study aimed to evaluate the effect of tannic acid on colonic anastomosis in a sepsis model induced by cecal abrasion. Materials and methods Thirty Sprague-Dawley rats were used. The animals were randomly divided into three groups of ten: Group 1 (n:10): Colonic anastomosis + 0.9% isotonic NaCl. Group 2 (n:10): Cecal ligation and puncture + Colonic anastomosis + 0.9% isotonic NaCl. Group 3 (n:10): Cecal ligation and puncture + Colonic anastomosis + Tannic Acid group. The rats were sacrificed on the fifth postoperative day, and the resected colon segments, bursting pressure, hydroxyproline levels, and histopathologic features of the anastomosis were evaluated. Results The bursting pressure value was statistically significantly higher in Group 3, where tannic acid was administered (p < 0.05). Group 2 and Group 3, in which peritonitis was induced, had moderate levels of fibroblastic activity, inflammatory cell infiltration, neovascularisation, and collagen; whereas, they were higher in Group 1. Although the inflammation value dropped in Group 3 compared to Groups 1 and 2, there was no statistical difference in Group 2. The hydroxyproline values were 2.046 ± 1.1411 mcg/gr and 5.9730 ± 4.35900 mcg/gr tissues, respectively, in Groups 2 and 3, where septic conditions prevailed, and a statistically significant difference was found (p < 0.05). Conclusion This experimental study revealed that the use of tannic acid during anastomosis has a positive effect on wound healing, acting through higher colonic anastomotic bursting pressures and higher tissue hydroxyproline levels.
Effect of luer-lock access device on hemolysis during blood collection via intravenous catheters in the emergency department
(Walter De Gruyter Gmbh, 2025) Cinpolat, Havva Yasemin; Akman, Canan; Şahin, Eda
Objectives Emergency departments are the units where hemolysis is most frequently observed, and blood collection from intravenous catheters increases the hemolysis rate. This study aimed to compare the effects of two different blood collection methods from an intravenous catheter (an adapter and a syringe) on serum indices, complete blood count, and routine clinical chemistry tests in an emergency department. Methods The study encompassed 104 patients from the yellow and green zones of the Emergency Department at Canakkale Onsekiz Mart University Hospital. Blood samples were obtained from an intravenous catheter with a standard syringe and an adapter into serum separator tubes and dipotassium ethylenediaminetetraacetic acid (K2EDTA) tubes. Serum index, aspartate aminotransferase (AST), creatine kinase (CK), lactate dehydrogenase (LDH), potassium, high-sensitivity (hs) troponin T, and complete blood count were evaluated. Passing-Bablok regression analysis was performed, and the mean percentage difference was calculated and compared to target values via a Bland-Altman plot. Results A statistically higher hemolysis rate was observed when blood was collected with a syringe, compared to collecting blood with an adapter (p<0.001). When the results were categorized according to the parameter-specific hemolysis index, AST, CK, potassium, LDH, and hs troponin T results were more affected by hemolysis when blood was collected with a syringe (p<0.001). The mean percentage difference for AST and LDH exceeded the minimum target values based on biological variation. Conclusions Using a catheter-compatible adapter in emergency departments may reduce the rate of hemolysis and provide reliable results for tests frequently affected by hemolysis.
Recurrent self-inflicted abdominal stab injuries leading case report and literature-backed review
(Turkish Assoc Trauma Emergency Surgery, 2025) Türker, Barış; Kurtkulağı, Özgür; Karacaer, Mehmet Ali; Gökten, Gökhan; Kaya, Mustafa
Meckel's diverticulum (MD) is a frequently silent congenital anomaly of the gastrointestinal tract. While complications such as bleeding and obstruction are more common, traumatic perforation remains extremely rare, particularly from penetrating injuries. To date, isolated perforation of MD following self-inflicted abdominal stab wounds has been reported only sporadically. We present the case of a 39-year-old male with a long-standing history of schizophrenia and epilepsy who arrived at the emergency department following his fifth self-inflicted abdominal stab injury over the past decade. On physical examination, a segment of small bowel was found protruding from a 4 cm periumbilical wound. Emergency exploratory laparotomy revealed extensive intra-abdominal adhesions and an isolated perforation of a Meckel's diverticulum located 60 cm proximal to the ileocecal valve. No other visceral injuries or hemorrhage were detected. The diverticulum was resected using a linear stapler, and serosal defects were repaired. The postoperative course was uneventful, and the patient was discharged on postoperative day five. Isolated MD perforation caused by penetrating abdominal trauma is exceedingly rare and diagnostically challenging. When occurring in psychiatric patients with repetitive self-harm behavior, it presents an even more complex scenario. This case underscores the importance of meticulous intra-abdominal exploration in stab wound patients and contributes novel insight to the limited literature on traumatic MD injuries.
Factors affecting one-year mortality in patients over 65 years of age undergoing surgery for hip fracture
(Turkish Assoc Trauma Emergency Surgery, 2025) Güneş, Zafer; Erdoğan, Eralp; Ceritoğlu, Kubilay Uğurcan; Aktekin, Cem Nuri
Objectives: In this study, our objective was to investigate the factors that affect 1-year mortality in patients over 65 years of age who were hospitalized due to hip fracture. Methods: This retrospective cohort study is based on data from our clinical archives collected between January 2013 and December 2021. All consecutive patients over 65 years of age with hip fractyres admitted to our hospital were considered for inclusion in the study. Results: During the period from January 2013 to December 2021, 834 patients met the inclusion criteria. The one-year mortality rate was 33.5 % (279/834). The mean surgery time was 5.64 days in patients with 1-year mortality; and 4.50 days in patients who lived longer than one year (P = 0,001). The mean values of hemoglobin, creatinine, lymphocyte count, and albumin of patients in the one-year mortality group were 11.47 g/dL, 1.33 mg/dL, 1.10x103/μL and 3.42 g/L, respectively. The same values of those who survived for more than a year were 11.93 g/dL, 1.12 mg/dL, 1.35x103/μL and 3.68 g/L, respectively (P= 0.006, 0.002, 0.001 and 0,000, respectively). Conclusions: We found that older patient age, delayed surgery, low albumin level, low total lymphocyte count, and high creatinine levels at hospital admission are associated with increased mortality after hip fracture. Comorbidities, number of comorbidities, transfusions, and ICU requirements were not associated with increased mortality, unlike the literature
First-trimester prediction of early-onset preeclampsia using PAPP-A and mean arterial pressure
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2025) Beyazıt, Fatma; Pek, Eren; Daş, Murat; Duran, Mehmet Nuri; Ülker Çakır, Dilek; Şen, Başak Nil; Kiraz, Hasan Ali; Ünal Çetin, Ece
Predicting early-onset preeclampsia (EOP) during the initial stages of pregnancy is essential for effective clinical management and enhancing maternal-fetal outcomes. Current methodologies, which include clinical and demographic risk factors, biophysical parameters, and serum biomarkers, exhibit limited efficacy in predicting EOP. This study aimed to evaluate whether the incorporation of pregnancy-associated plasma protein-A (PAPP-A) and mean arterial pressure (MAP) significantly enhances EOP detection. We conducted a retrospective case-control study involving 518 gravidas, of whom 202 developed EOP and 316 experienced normal pregnancies. Logistic regression models were employed to assess EOP predictions, and the predictive accuracy of these statistical models was evaluated using receiver-operating characteristic curve analysis. Our findings indicate that lower PAPP-A levels, higher MAP, and increased body mass index (BMI) are associated with EOP. Notably, in pregnant women between 11+0 and 13+6 weeks of gestation, a 1-point decrease in PAPP-A corresponds to an 84% increase in the likelihood of developing EOP. The predictive performance of PAPP-A improves significantly when combined with other factors such as BMI, MAP, and a history of diabetes mellitus (DM). The risk of EOP is substantially heightened (20.410 times, 95% CI: 11.104-37.515) in patients exhibiting low PAPP-A levels (<0.88) and high BMI (≥35 kg/m²). Additionally, low PAPP-A combined with elevated MAP levels significantly increases EOP risk (adjusted odds ratio [OR]: 114.83). However, after adjustment, the association between low PAPP-A and a history of DM was not statistically significant (adjusted OR: 2.30, p = 0.202). In conclusion, employing a combination of multiple variables for predicting EOP yields a significant improvement over traditional methods that rely solely on individual factors.
Development of a novel clinical prediction model for sepsis related mortality by combining NEWS, PIRO and lactate
(Assoc Basic Medical Sci Federation Bosnia & Herzegovina Sarajevo, 2025) Kurtkulağı, Özge; Ünal Çetin, Ece; Kamış, Fatih; Daş, Murat; Şimşek, Esen; Kurtkulağı, Özgür; Çetin, Adil Uğur; Beyazit, Yavuz
Prognostic assessment plays a crucial role in guiding therapeutic decision-making for patients with sepsis, particularly in intensive care settings. This study aimed to develop a multivariable model to predict 28-day mortality among intensive care unit (ICU) patients with sepsis by integrating serum lactate levels, the National Early Warning Score (NEWS), and the Predisposition, Infection, Response, and Organ Dysfunction (PIRO) score. Demographic information, clinical characteristics, and laboratory findings routinely collected at ICU admission were used to calculate the NEWS and PIRO scores for each patient. Patients were categorized as survivors or non-survivors based on their outcome. Both logistic regression and Cox proportional hazards models were applied for mortality prediction analysis. The final analysis included 205 patients diagnosed with sepsis (mean age: 73.6 +/- 13.2 years; 53.2% male), of whom 109 died during hospitalization. Logistic regression analysis revealed that lactate, NEWS, and PIRO scores were independently associated with 28-day mortality. Combining lactate levels with NEWS and PIRO significantly enhanced mortality prediction, with the greatest accuracy observed when all three parameters were integrated. Pairwise analyses demonstrated that adding lactate to the base model significantly improved predictive accuracy (DBA: -0.103, p = 0.003), and incorporating lactate into a model already including NEWS further enhanced its predictive value (DBA: -0.042, p = 0.037). In conclusion, serum lactate measured at initial ICU admission provides valuable prognostic information for predicting 28-day mortality in sepsis patients. Furthermore, combining lactate levels with NEWS and PIRO scores substantially enhances the accuracy of mortality prediction in these patients.
Oxidative stress in preeclampsia: A comparative biomarker analysis across body mass index categories
(Sciendo, 2025) Çakına, Suat; Postacı, Emine Sevinç; Beyazıt, Fatma
Background Preeclampsia is a complex form of prenatal hypertension associated with endothelial dysfunction, systemic inflammation, and oxidative stress. This study aimed to determine the amounts of malondialdehyde, total oxidant status, and oxidative stress index in the blood of pregnant women with preeclampsia and controls, as well as how these parameters varied with body mass index. Methods The present study was a case-control study carried out in the Department of Obstetrics and Gynecology, Faculty of Medicine & Ccedil;anakkale Onsekiz Mart University, Turkiye, from July 2023 to May 2025. The study included 50 pregnant women with preeclampsia and 50 with normotension (control group). They were divided into three groups: normal weight, overweight, and obese, using body mass index. Serum malondialdehyde, total oxidant capacity, total antioxidant capacity, and oxidative stress index levels were measured using validated spectrophotometric techniques. Statistical analyses were performed using SPSS version 25.0, with a significance level of p<0.05. Results Malondialdehyde, total oxidant capacity, and oxidative stress index levels were significantly higher in the preeclampsia group than in the control group. Compared with the control group, total antioxidant capacity levels were significantly lower, particularly in the obese preeclampsia subgroup (p<0.05). Conclusions According to this study, preeclamptic women's oxidative stress rose as their body mass index rose. Our study's observed values suggest that they may be applied as prognostic or diagnostic biomarkers for preeclampsia. Our research might help create tailored risk evaluations and focused antioxidant treatments for high-risk pregnancies.
Early-Term Results of Endovenous Saphenous Vein Radiofrequency Ablation Combination with Trans-sheath Ultrasound-Guided Foam Sclerotherapy
(Coll Physicians & Surgeons Pakistan, 2025) Oğuz, Sonay
Objective: To determine the early success rate in cases of great saphenous vein insufficiency treated with radiofrequency ablation (RFA) and combined transsheath ultrasonography-guided foam sclerotherapy (RFA+ST). Study Design: Descriptive study. Place and Duration of the Study: Department of Cardiovascular Surgery, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Turkiye, from July 2022 to October 2024. Methodology: Patients who underwent only RFA and combined RFA+ST between July 2022 and October 2024 were retrospectively scanned. Demographic data and complications were recorded. Differences between the demographic and collected data of the two groups were examined using the Mann-Whitney U test, Pearson’s Chi-square or Fisher’s exact test. Results: In total, 235 patients were included in the study: 120 in the RFA group (Group A) and 115 in the RFA+ST group (Group B). The median age (IQR) of Groups A and B was 48 (24) and 50 (26) years, respectively. The gender distribution was 86 females (65.6%) and 45 males (34.4%) in Group A, 75 females (67%) and 37 males (33%) in Group B. The median GSV diameter was 6.7 (1.5) mm and 7 (1.7) mm, respectively. Recanalisation occurred in 8 (6.1%) patients in Group A and 1 (0.9%) patient in Group B (p = 0.041). Other complications in Groups A and B included tenderness [7 (5.3%) vs. 12 (10.7%)], phlebitis or cellulitis [4 (3.1%) vs. 2 (1.8%)], ecchymosis [1 (0.8%) vs. 2 (1.8%)], hyperpigmentation [5 (3.8%) vs. 2 (1.8%)], and phlebothrombosis [7 (5.3%) vs. 24 (21.4%); p <0.001], respectively. Conclusion: In Group B combined with foam sclerotherapy, recanalisation rate was found to be significantly lower, and phlebothrombosis was higher in the early period. Closure reactions may develop more strongly with phlebothrombosis; however, appropriate case selection and procedure should be performed very carefully due to possible adverse conditions such as deep vein thrombosis.

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